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罕见的双侧变异型喙肱肌,具有额外的头和共存的臂丛神经和腋动脉变异分支模式。

A rare bilateral variant of the coracobrachialis muscle with supernumerary heads and coexisted variant branching patterns of the brachial plexus and the axillary artery.

机构信息

Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Goudi, 11527, Athens, Greece.

Department of Anatomy and Surgical Anatomy, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Surg Radiol Anat. 2023 Mar;45(3):277-282. doi: 10.1007/s00276-023-03088-w. Epub 2023 Jan 24.

Abstract

PURPOSE

The study report describes a rare bilateral variant of a six- and five-headed coracobrachialis muscle (CB). The musculocutaneous nerve (MCN) (bilaterally) and the median nerve (MN) lateral root (unilaterally) pierced CB heads, separating superficial from deep heads.

METHODS

The variant bilateral CB was identified in a 78-year-old formalin-embalmed male cadaver, derived from a body donation program after a signed informed consent.

RESULTS

At the right side: The 6-headed CB was pierced by the MCN, while the MN lateral root pierced the one superficial and deep head. CB was supplied by the lateral cord and the MCN. At the left side: A 5-headed CB was identified with three superficial distinct origins that fused into a common superficial head coursing anterior to MCN. The variant CB bilaterally (with 11 heads in total) coexisted with a MN variant formation, an atypical course of the MN lateral root through CB (right side), a connection of the MN lateral root with the MCN (left side) and a variant axillary artery branching pattern (bilaterally).

CONCLUSIONS

Course and direction of the accessory CB heads may occasionally entrap the MCN and/or adjacent structures (brachial artery and MN). The MCN compression results in problems in the glenohumeral joint flexion and adduction, and tingling or numbness of the elbow joint, the forearm lateral parts and the hand.

摘要

目的

本研究报告描述了一种罕见的双侧六头和五头喙肱肌(CB)变体。肌皮神经(MCN)(双侧)和正中神经(MN)外侧根(单侧)穿过 CB 头,将浅层头与深层头分开。

方法

在一个 78 岁的福尔马林固定男性尸体中发现了这种变体双侧 CB,该尸体来自于一个经过签署知情同意的遗体捐献计划。

结果

在右侧:6 头 CB 由 MCN 穿过,而 MN 外侧根穿过一个浅层和深层头。CB 由外侧束和 MCN 供应。在左侧:发现了一个 5 头 CB,有三个明显的浅层起源,融合成一个位于 MCN 前方的共同浅层头。双侧变体 CB(总共 11 个头)共存 MN 变体形成、MN 外侧根通过 CB 的异常走行(右侧)、MN 外侧根与 MCN 的连接(左侧)和变体腋动脉分支模式(双侧)。

结论

辅助 CB 头的走行和方向可能偶尔会夹住 MCN 和/或相邻结构(肱动脉和 MN)。MCN 受压导致肩关节屈曲和内收问题,以及肘部、前臂外侧部分和手部的刺痛或麻木。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e430/9981499/9c5022c592f9/276_2023_3088_Fig1_HTML.jpg

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